Anatomy Palpation OSCE Prep

Name of Bony Landmark Coracoid process

Location/Significance Bony projection Finger-like shape Anterior scapula Medial to it is the rib cage Superior to it is the clavicle Lateral to it is the head of the humerus Can be palpated about 2 finger widths below the lateral clavicle Attachment site for muscles: - Bicep brachii - Coracobrachialis - Pectoralis minor - Attachment site for ligaments: - Coracoacromial ligament - Coracohumeral ligament - Bony projection - Found on the posterior scapula - Runs transversely across the scapula, about 1/3 of the way down - Lateral end is the acromion - Medial end is the root - Superior to it is the supraspinatus muscle in the supraspinous fossa - Inferior to it is the infraspinatus muscle in the infraspinous fossa - Attachment site for muscles: - Deltoid - Trapezius - Bony projection - Found on the scapula - Lateral end of the spine of the scapula - Subacromial bursa inferior to it - Medial to it is the coracoid process - Inferior to it is the head of the humerus - Supraspinatus muscles runs underneath it - Attachment site for muscles: - Deltoid - Trapezius - Attachment site for ligaments: - Coracoacromial ligament - Bony projection - Found at the proximal end of the humerus - Lateral to it is the bicipital groove & greater tubercle - Medial to it is the coracoid process - Inferior to it is the shaft of the humerus - It is deep to the deltoid muscle - Attachment site for muscles: - Subscapularis

Spine of the scapula

Acromion

Lesser tubercle

Greater tubercle

Deltoid tuberosity

Radial styloid process

Lateral epicondyle

Medial epicondyle -

Bony projection Found on the proximal humerus Medial to it is the bicipital groove & lesser tubercle Inferior to it is the shaft of the humerus It is deep to the deltoid muscle Attachment site for 3 of the rotator cuff muscles: - Infraspinatus - Supraspinatus - Teres minor Bony projection Found on the mid shaft of the humerus Lateral to it is the tricep brachii Medial to it is the bicep brachii Superior to it is the upper shaft of the humerus Inferior to it is the lower shaft of the humerus Attachment site for muscles: - Deltoid Proximal end of the brachialis muscle forms a V around the deltoid attachment at the deltoid tuberosity Bony projection Found at the distal end of the radius On the lateral side of the forearm Points down toward the thumb Proximal to it is the shaft of the radius Medial to it is the ulna Distal to it is the scaphoid & some of the lunate Attachment site for muscles: - Brachioradialis Bony projection Found at the distal end of the humerus Medial to it is the olecranon (posteriorly) & cubital fossa (anteriorly) Proximal to it is the supracondylar ridge & shaft of the humerus Distal to it is the shaft of the radius Attachment site for the common extensor tendon & muscles: - Extensor digitorum - Extensor digiti minimi - Extensor carpi radialis brevis - Extensor carpi ulnaris Attachment site for muscles: - Anconeus - Supinator Attachment site for ligaments: - Radial collateral ligaments Inflammation of the CET or lateral epicondyle can cause lateral epicondylitis/epicondylosis/tennis elbow Bony projection Found at distal end of the humerus Lateral to it is the olecranon (posteriorly) & cubital fossa (anteriorly) posterior to it is the supracondylar ridge & shaft of the humerus

Olecranon -

Flexor retinaculum

Common flexor tendon

Ulnar nerve runs by it, causing the pain when you hit your funny bone Inferior to it is the shaft of the ulna Attachment site for common flexor tendon & muscles: - Pronator teres - Flexor carpi ulnaris - Palmaris longus - Flexor carpi radialis - Flexor digitorum superficialis Attachment site for muscles: - Flexor pollicis longus Inflammation of the CFT or epicondyle can cause medial epicondyitis/epicondylosis/golfers elbow Body projection Located on posterior side of the arm Is easily palpable Found at proximal end of ulna Medial to it is the medial epicondyle & ulnar nerve Lateral to it is the later epicondyle Superior to it is the shaft of the humerus Inferior to it is the shaft of the ulna Formed by the trochlear notch forming a hinge joint onto the trochlea of the humerus Attachment site for muscles: - Tricep brachii - Anconeus - Flexor carpi ulnaris Aka transverse carpal ligament Ligament that covers the carpal bones of the wrist Forms the carpal tunnel Muscle tendons pass through the tunnel: - Flexor digitorum profundus (4 tendons) - Flexor digitorum superficialis (2 rows of 2 tendons) - Flexor pollicis longus Median nerve also runs through the tunnel Palmaris longus tendon is superficial to it Attachment site for muscles of the thenar eminence: - Flexor pollicis brevis - Abductor pollicis brevis - Opponens pollicis Attachment site for 2 of the hypothenar eminence muscles: - Flexor digiti minimi - Opponens digiti minimi Inflammation of the carpal tunnel causes carpal tunnel syndrome Tendon Located on the medial epicondyle Common site for muscle tendon attachment: - Pronator teres - Flexor carpi ulnaris - Palmaris longus - Flexor carpi radialis

Inferior surface of the clavicle

Bicipital groove

Coronoid process

Common extensor tendon

Medial border of the scapula -

Flexor digitorum superficialis Superior to it is the supracondylar ridge & shaft of the humerus - Distal to it is the ulna - Lateral to it is the cubital fossa - Inflammation of the CFT or epicondyle can cause medial epicondylitis/epicondylosis/golfers elbow Flat bone Aka collarbone Lateral to it is the acromion Medial to it is the sternum Sternoclavicular joint Acromioclavicular joint Inferior to it are the ribs Attachment site for muscles: - Subclavius (dynamic ligament) Aka intertubucular sulcus It is a groove located at the proximal end of the humerus Medial to it is the lesser tubercle Lateral to it is the greater tubercle Inferior to it is the shaft of the humerus Attachment site for muscles: - Pectoralis major - Latissimus dorsi - Teres major Deep to the deltoid muscle It has a medial & lateral lip The long head of bicep brachii goes through it Bony projection Located at the proximal end of the ulna Located in the cubital fossa Fits into the coronoid fossa of the humerus during flexion Attachment site for muscles: - Pronator teres - Brachialis - Flexor digitorum superficialis - Flexor pollicis longus (sometimes) Tendon Located on the lateral epicondyle Medial to it is the cubital fossa Inferior to it is the shaft of the radius Superior to it is the supracondylar ridge & shaft of the humerus Attachment site for muscles: - Extensor digitorum - Extensor digiti minimi - Extensor carpi ulnaris - Extensor carpi radialis brevis Inflammation of the tendon or epicondyle is lateral epicondylitis/epicondylosis/tennis elbow 1 of 3 borders located on the scapula Closest one to the spine

Lateral border of the scapula

Ulnar tuberosity

Radial tuberosity

Scaphoid

Lunate

Pisiform

It ends superiorly at the superior angle It ends inferiorly at the inferior angle About 1/3 down, there is a tubercle at the root of the spine Lateral to it is the supraspinatus muscle in the supraspinous fossa Lateral to it is the infraspinatus muscle in the infraspinous fossa Attachment site for muscles: - Rhomboids major & minor - Levator scapulae - Serratus anterior (anterior side) 1 of 3 borders on the scapula Furthest one from the spine Closest to the lateral side of the body Superiorly it ends at the infraglenoid fossa infraglenoid tubercle Inferiorly it ends at the inferior angle Attachment site for muscles: - Teres major & minor Bony projection Located at the proximal end of the ulna Distal to it is the attachment site of flexor digitorum profundus Lateral to it is the radius (radial tuberosity) Attachment site for muscles: - Brachialis Bony projection Located at the proximal end of the radius Superior to it is the radioulnar joint Medial to it is the ulna (ulnar tuberosity) Inferior to it is the shaft of the radius & interosseous membrane Attachment site for muscles: - Bicep brachii 1 of 8 carpal bones Forms the wrist In the proximal row of carpal bones It is a short bone Proximal to it is the radius Distal to it is the trapezium Medial to it is the lunate Also articulates with the trapezoid & capitate Can be palpated through the anatomical snuffbox Attachment site for 1 of the muscles of the thenar eminence: - Abductor pollicis brevis 1 of 8 carpal bones Forms the wrist In the proximal row of carpal bones It is a short bone Proximal to it is the radioulnar joint Medial to it is the triquetrum Lateral to it is the scaphoid Distal to it is the capitate 1 of 8 carpal bones Forms the wrist In the proximal row of carpal bones

Trapezium

Capitate

Hamate

1st metacarpal

It is a short bone Sits on top of the triquetrum Distal to it is the hamate Lateral to it is the lunate Easily palpable Attachment site for muscles: - Abductor digiti minimi - Flexor carpi ulnaris 1 of 8 carpal bones Forms the wrist It is a short bone In the distal row of carpals Deep to the flexor retinaculum Distal to it is the 1st metacarpal (carpometacarpal joint) Proximal to it is the scaphoid Medial to it is the trapezoid Has a tubercle Forms the carpal tunnel Attachment site for muscles: - Flexor pollicis brevis - Abductor pollicis brevis - Opponens pillicis 1 of 8 carpal bones Forms the wrist It is a short bone In the distal row of carpal bones Deep to the flexor retinaculum Medial to it is the hamate Lateral to it is the trapezoid Distal to it is the 3rd metacarpal (carpometacarpal joint) Proximal to it is the lunate & scaphoid Attachment site for muscles: - Adductor pollicis 1 of 8 carpal bones Forms the wrist It is a short bone In the distal row of carpal bones Deep to the flexor retinaculum Forms the carpal tunnel Has a hook Lateral to it is the capitate Distal to it is the 4th & 5th metacarpals (carpometacarpal joints) Proximal to it is the triquetrum & pisiform Attachment site for muscles: - Flexor carpi ulnaris - Flexor digiti minimi - Opponens digiti minimi 1 of 5 in the palm of the hand Forms the thumb Long bone Has 2 sesamoid bones

3rd metacarpal

5th metacarpal

Lateral supracondylar ridge

Medial supracondylar ridge

Dorsal digital expansion

Distal to it is the proximal phalanx (metacarpophalangeal joint) Proximal to it is the trapezium (carpometacarpal joint) Attachment site for muscles: - Dorsal interossei - Opponens pollicis - Abductor pollicis longus 1 of 5 in the palm of the hand Forms the middle finger Long bone Distal to it is the proximal phalanx of middle finger (metacarpophalangeal joint) Proximal to it is the capitate (carpometacarpal joint) Attachment site for muscles: - Dorsal interossei - Palmar interossei - Adductor pollicis - Flexor carpi radialis - Extensor carpi radialis brevis 1 of 5 in the palm of the hand Forms the little finger Long bone Distal to it is the proximal phalanx of the little finger (metacarpophalangeal joint) Proximal to it is the hamate (carpometacarpal joint) Attachment site for muscles: - Flexor carpi ulnaris - Extensor carpi ulnaris - Dorsal interossei - Palmar interossei - Opponens digiti minimi Ridge at the distal end of the humerus Inferior to it is the lateral epicondyle Proximal to it is the shaft of the humerus Attachment site for muscles: - Brachioradialis - Extensor carpi radialis longus Ridge at the distal end of the humerus Inferior to it is the medial epicondyle Proximal to it is the shaft of the humerus Attachment site for muscles: - Pronator teres Fibrous aponeurosis Network of fascia on posterior fingers Continuation of the extensor digitorum Goes all the way to the distal phalanx of the fingers Lies on the medial & lateral border of proximal phalanx Lies on the posterior side of the middle & distal phalanx Aka extensor expansion or dorsal hood Attachment site for muscles: - Dorsal interossei - Palmar interossei

Anatomical snuffbox

- Lumbricals - Extensor digiti minimi - Extensor indicis - Abductor digiti minimi Indentation of the lateral posterior side of the hand Formed by 3 tendons of the deep distal four muscles Lateral edge is tendons of muscles: - Extensor pollicis brevis - Abductor pollicis longus These 2 tendons are wrapped in the same sheath Inflammation of these 2 tendons is De Quarvains syndrome Medial edge is tendon of muscles: - Extensor pollicis longus Scaphoid can be palpated through it Distal to it is the 1st metacarpal Proximal to it is the radius